Yearbook of Anesthesiology-4 Raminder Sehgal, Anjan Trikha, Baljit Singh
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1Yearbook of Anesthesiology-42
3Yearbook of Anesthesiology-4
Editors Raminder Sehgal MD DA FICA Ex-Director Professor Maulana Azad Medical College, New Delhi, India Ex-Senior Consultant Sir Ganga Ram Hospital, New Delhi, India Anjan Trikha MD FICA Professor All India Institute of Medical Sciences, New Delhi, India Baljit Singh MD FICA Director Professor GB Pant Hospital, New Delhi, India Editorial Board Members VP Kumra MD DAc FICA Emeritus Consultant Sir Ganga Ram Hospital, New Delhi, India President Indian College of Anaesthesiologists B Radhakrishnan MD MPhil FICA Principal Academy of Medical Sciences Kannur, Kerala, India SM Basu MD DA (London) FICA Ex-President Indian Society of Anaesthesiologists
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Yearbook of Anesthesiology-4
First Edition: 2015
9789351526582
Printed at
5Contributors
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9Foreword
The Indian College of Anaesthesiologists (ICA) was established in November, 2008 as an academic branch of Indian Society of Anaesthesiologists, with an aim to provide uniformity in education and training all over the country and to standardize the anesthetic procedures for international accreditation of our qualifications. It was with this aim that the 1st Yearbook of Anesthesia was released in 2011. Two subsequent editions have come out most successfully and encouragingly.
This issue of Yearbook of Anesthesiology is the fourth in the series. There are 25 subjects of great interest to the anesthesiologists included in this edition. Great care has been taken in selection of the authors who have good experience in their field. While keeping the similarity with previous three issues, the new editorial team headed by Professor Raminder Sehgal has introduced a feature in the form of “Journal Scan” wherein a few recent landmark publications have been reviewed by renowned anesthesiologists. This is definitely going to be most informative for the practising anesthesiologists and postgraduate students. All the chapters have been meticulously chosen and authored by the clinicians of authority in their field. I wish to congratulate the editorial team, including Professor Anjan Trikha and Professor Baljit Singh and the editorial board members Dr VP Kumra, Dr B Radhakrishnan, and Dr SM Basu for their commendable work.
Manorma Mittal
Former Head of the Department
MAMC and Associated Hospitals
Common Wealth Scholarship Awardee
Dr BC Roy National Awardee
Past President ISA
Patron ICA10
11Preface
The fourth volume of the Yearbook is in your hands with 25 chapters that contain all the relevant updates in the respective topics. The last three Yearbooks have had tremendous success with the need of reprints after the initial volumes were released. The previous copies have been distributed and bought all over India and the neighboring countries. For this volume, the editorial team has been changed. The present team goes on record to appreciate the efforts made by, first to conceptualize this idea of publishing a yearbook under the auspices of the Indian College of Anaesthesiologists, and then to make the book so very popular. The change that has been done in the present format is inclusion of expert opinion on certain landmark articles published during the last year, which are likely to change clinical practice. The topics include general anesthesia, pain and intensive care.
The editorial team has endeavored to include variety of topics that represent all aspects of anesthesia practice. While three chapters discuss the anesthesia management of patients presenting with burns, renal transplant and carotid endarterectomy, the chapter on iatrogenic hyponatremia deals with complications arising from use of irrigation fluids used during endoscopic, urologic and gynecologic surgery. Anesthesia in the MRI suite outlines the problems due to strong magnetic field and the MRI compatible equipment required for patient management. There is an interesting write-up on the status of nitrous oxide in the modern-day anesthesia practice and another chapter re-looks on the commonly practiced brachial plexus block. Current concepts of perioperative fluid therapy and management of postoperative nausea and vomiting (PONV) have also been included.
With burgeoning aging population, the ever-increasing number of elderly patients are presenting for surgery, and most of them have cardiovascular comorbidity. Two chapters deal with the anesthetic implications of diastolic dysfunction and implanted cardiac devices. On the other extreme of age, one lung anesthesia in children has been dealt with in detail. Obesity is turning out to be a worldwide epidemic and a large number of these patients have obstructive sleep apnea which may be undiagnosed preoperatively. The diagnosis and anesthetic management of these patients have been discussed as also the management of patients presenting for liposuction, a very common esthetic procedure in the obese.
Maternal and child health is our national agenda and recent advances in the management of obstetric hemorrhage have been discussed in detail in one of the chapters. Fetal surgery gives an opportunity to treat congenital abnormalities in utero, which, if untreated, may lead to death or severe disability after birth. The chapter on fetal surgery outlines the conditions amenable to surgery and the anesthetic management of the same. Technology has entered our operation theaters in a big way and one must know the intricacies of ultrasound, point-of-12care coagulation testing and the monitoring issues during complex spine surgery. The operation theater atmosphere can impact the personnel working there. With this in mind, a chapter on the environmental issues in the operating theaters is included. Care has also been taken to include topics related to management of pain and critical care; the two important areas of anesthesia practice. The chapter on opioids deals with newer opioids as well as the new methods of delivery of older opioids, and the chapter on implantable devices discusses the implantable pain therapy devices for management of chronic and cancer pain. Recent developments in the management of acute respiratory dispress syndrome (ARDS) and noncardiogenic pulmonary edema are also discussed.
The editorial team is sure that the present volume would live up to the reader's expectations but would welcome any criticism/suggestions so that the next edition can be made even better.
The editors are grateful to their distinguished colleagues who have spared time from their busy schedule to contribute to this volume.
We hope the readers find the chapters in this volume stimulating and interesting.
Raminder Sehgal
Anjan Trikha
Baljit Singh